Question

Order: Levaquin 350 mg is added to 500 mL D5W to infuse over 8 hours. Drop factor: 10 gtt/mL. For IV reconstitute with 1o mL. of diluent to get 100 mg per 10 mL. (Consider the medication added in the volume of fluid.) Calculate the rate in gtt/min at which the IV should infuse

Answer 1

Correct Answers:

10 gtt/min

Rationale :

🔷 Step 1: Total Volume to Infuse = 500 mL

(The medication is already added into the 500 mL D5W.)

🔷 Step 2: Total Infusion Time = 8 hours

8 hours × 60 minutes/hour = 480 minutes

🔷 Step 3: Drop Factor = 10 gtt/mL

🔷 Step 4: Apply the formula:

Flow rate (gtt/min) = Total volume (mL) × Drop factor (gtt/mL) ÷ Time (min)

Flow rate = 500 × 10 ÷ 480 = 5000 ÷ 480 = 10.4 ≈ 10 gtt/min

🔷 Final Answer: Round to the nearest whole number → 10 gtt/min

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Answer 2

Correct Answers:

78 gtt/min

Rationale :

🔶 Step 1: Total volume to infuse = 2,500 mL

🔶 Step 2: Total time = 8 hours × 60 minutes = 480 minutes

🔶 Step 3: Drop factor = 15 gtt/mL

🔶 Apply the formula:

Flow rate (gtt/min) = Total volume (mL) × Drop factor (gtt/mL) ÷ Time (min)

Flow rate = 2500 × 15 ÷ 480 = 37,500 ÷ 480 = 78.1 ≈ 78 gtt/min

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Answer 3

Correct Answers:

0.3 mL

Rationale :

🔷 Step 1: Ordered dose = 15 mg

🔷 Step 2: Available concentration = 50 mg/mL

🔷 Use the formula:

Dose to give (mL) = Ordered dose (mg) ÷ Available concentration (mg/mL)

Dose = 15 ÷ 50 = 0.3 mL

🔷 This is the exact volume needed to administer 15 mg of Vistaril using a 50 mg/mL solution.

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Answer 4

Correct Answers:

Vomiting
Nausea
Blurred Vision

Rationale :

🌿 A. Vomiting

🌿 Vomiting is a prominent gastrointestinal symptom that occurs early in digoxin toxicity.

🌿 It is caused by stimulation of the chemoreceptor trigger zone (CTZ) in the medulla, which reacts to elevated digoxin levels.

🌿 Clients may vomit repeatedly, even without food intake, due to the toxic buildup of the drug.

🌿 This symptom is especially important to recognize in elderly clients or those with impaired kidney function, where toxicity develops more easily.

🌿 Vomiting can also lead to fluid and electrolyte imbalances, which may further increase the risk of arrhythmias.

🌿 B. Nausea

🌿 Nausea often appears before cardiac disturbances, making it a key early warning sign.

🌿 It results from the drug’s action on the GI tract and central nervous system.

🌿 Clients may describe feeling queasy, lightheaded, or unable to eat, even with mild digoxin elevation.

🌿 Persistent nausea should prompt immediate evaluation of digoxin levels and renal function.

🌿 It can be misinterpreted as a viral illness or poor appetite unless connected with other symptoms of toxicity.

🌿 C. Blurred Vision

🌿 Blurred vision is a classic neuro-visual symptom seen in moderate to severe digoxin toxicity.

🌿 Clients may report seeing halos around lights, especially in dim lighting.

🌿 Another hallmark sign is xanthopsia, or yellow-green discoloration in vision.

🌿 These visual effects occur due to digoxin’s action on the retinal cells and optic nerve conduction.

🌿 Because these signs are specific to digoxin, their presence strongly suggests toxicity and should be reported and investigated immediately.

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Answer 5

Correct Answers:

Quinapril

Rationale :

💊 Quinapril is classified as an angiotensin-converting enzyme (ACE) inhibitor.

💊 It works by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, which results in vasodilation and lowered blood pressure.

💊 ACE inhibitors like quinapril are used to treat hypertension, heart failure, and help protect the kidneys in diabetic patients.

💊 Common side effects include dry cough, hyperkalemia, and angioedema, which require monitoring.

💊 Patients taking quinapril should also be educated to avoid potassium supplements and report swelling or persistent cough.

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Answer 6

Correct Answers:

13.6 mL/hr

Rationale :

🔶 Step 1: Determine total units per hour

9 units/kg/hr × 76 kg = 684 units/hr

🔶 Step 2: Concentration of Heparin = 50 units/mL

🔶 Step 3: Use the formula

mL/hr = Ordered dose (units/hr) ÷ Concentration (units/mL)

mL/hr = 684 ÷ 50 = 13.68 mL/hr

🔶 Step 4: Round to the nearest tenth

13.68 → 13.6 mL/hr

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Answer 7

Correct Answers:

Limit salt intake

Rationale :

🧂 Limiting salt (sodium) intake is a key nonpharmacological strategy in managing heart failure.

🧂 Sodium promotes water retention, which increases fluid volume, leading to worsened edema, pulmonary congestion, and increased cardiac workload.

🧂 A low-sodium diet (usually <2,000 mg/day) helps reduce fluid accumulation, improving symptom control and preventing hospital readmissions.

🧂 Patients are educated to read food labels, avoid processed foods, and not add table salt to meals.

🧂 Combined with other lifestyle measures like daily weights and fluid restriction (if ordered), sodium limitation is essential in managing chronic heart failure.

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Answer 8

Correct Answers:

150 gtt/min

Rationale :

💉 Calculation Steps:

💉 Step 1: Total Volume = 100 mL

💉 Step 2: Infusion Time = 30 minutes

💉 Step 3: Drop Factor = 60 gtt/mL

💉 Apply the formula:

Flow rate (gtt/min) = Volume (mL) × Drop factor (gtt/mL) ÷ Time (min)

Flow rate = 100 × 60 ÷ 30 = 6000 ÷ 30 = 150 gtt/min

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Answer 9

Correct Answers:

200 mL/hr

Rationale :

🧪 Step 1: Volume to infuse = 180 mL

🧪 Step 2: Time = 40 minutes → Convert to hours: 40 ÷ 60 = 0.67 hours

🧪 Step 3: Apply the formula:

Flow rate (mL/hr) = Volume (mL) ÷ Time (hr)

Flow rate = 180 ÷ 0.67 ≈ 268.65, round to nearest whole number = 270 mL/hr

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Answer 10

Correct Answers:

Check the apical pulse D.

Rationale :

🫀 Digoxin slows conduction through the atrioventricular (AV) node, lowering heart rate.

🫀 The apical pulse must be assessed for 1 full minute before administering the drug.

🫀 If the pulse is less than 60 bpm in adults, the dose should be withheld and the provider notified.

🫀 This is done to prevent severe bradycardia or heart block, especially in clients with digoxin sensitivity.

🫀 It is a standard safety protocol in digoxin administration and critical for preventing cardiac complications.

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QLexNursing

1 :
Order: Levaquin 350 mg is added to 500 mL D5W to infuse over 8 hours. Drop factor: 10 gtt/mL. For IV reconstitute with 1o mL. of diluent to get 100 mg per 10 mL. (Consider the medication added in the volume of fluid.) Calculate the rate in gtt/min at which the IV should infuse

2 :
Calculate the flow rate in gtt/min using the formula method. Administer 2.500 mL. D5 0.33% NS in 8 hr. The drop factor is 15 grt/mL

3 :
Samantha Hudson a two-year-old child in the ER with parents at the bedside. She came in not feeling well, irritable, crying all night, and not eating or drinking. Orders: Vistaril 15 mg IM q4h, Stat x 1 for nausea. Available: Vistaril 50 mg/mlnHow many mL will you administer to Samantha now?

4 :
A person with digoxin toxicity would have which of these symptoms? (Select All that Apply)

5 :
A patient asks the nurse to explain the medications they are taking. Which medication would be considered an angiotensin converting enzyme inhibitor?

6 :
A doctor orders nine units /kg/hr for a Heparin infusion. The patient weighs 76 kg. You're supplied with a Heparin bag that reads 50 untis/mL. How many mL/hr will you administer? |Round your answer to the nearest tenths)

7 :
Nonpharmacological treatment of heart failure includes:

8 :
Order: Zosyn 1.3g in 100mL. D5W IVPB q8h to infuse over 30 min. Drop factor: 60 gtt/mL. Determine rate in gtt/min.

9 :
Calculate the flow rate in mL/hr. (Equpment used is programmable in whole mL/hr) 180 mL 0.45% NS in 40 min by infusion group

10 :
Before administering digoxin, it is Important for the nurse to do which of the following?

QLexNursing

1 : Order: Levaquin 350 mg is added to 500 mL D5W to infuse over 8 hours. Drop factor: 10 gtt/mL. For IV reconstitute with 1o mL. of diluent to get 100 mg per 10 mL. (Consider the medication added in the volume of fluid.) Calculate the rate in gtt/min at which the IV should infuse

2 : Calculate the flow rate in gtt/min using the formula method. Administer 2.500 mL. D5 0.33% NS in 8 hr. The drop factor is 15 grt/mL

3 : Samantha Hudson a two-year-old child in the ER with parents at the bedside. She came in not feeling well, irritable, crying all night, and not eating or drinking. Orders: Vistaril 15 mg IM q4h, Stat x 1 for nausea. Available: Vistaril 50 mg/mlnHow many mL will you administer to Samantha now?

4 : A person with digoxin toxicity would have which of these symptoms? (Select All that Apply)

5 : A patient asks the nurse to explain the medications they are taking. Which medication would be considered an angiotensin converting enzyme inhibitor?

6 : A doctor orders nine units /kg/hr for a Heparin infusion. The patient weighs 76 kg. You're supplied with a Heparin bag that reads 50 untis/mL. How many mL/hr will you administer? |Round your answer to the nearest tenths)

7 : Nonpharmacological treatment of heart failure includes:

8 : Order: Zosyn 1.3g in 100mL. D5W IVPB q8h to infuse over 30 min. Drop factor: 60 gtt/mL. Determine rate in gtt/min.

9 : Calculate the flow rate in mL/hr. (Equpment used is programmable in whole mL/hr) 180 mL 0.45% NS in 40 min by infusion group

10 : Before administering digoxin, it is Important for the nurse to do which of the following?

1 :
Order: Levaquin 350 mg is added to 500 mL D5W to infuse over 8 hours. Drop factor: 10 gtt/mL. For IV reconstitute with 1o mL. of diluent to get 100 mg per 10 mL. (Consider the medication added in the volume of fluid.) Calculate the rate in gtt/min at which the IV should infuse

2 :
Calculate the flow rate in gtt/min using the formula method. Administer 2.500 mL. D5 0.33% NS in 8 hr. The drop factor is 15 grt/mL

3 :
Samantha Hudson a two-year-old child in the ER with parents at the bedside. She came in not feeling well, irritable, crying all night, and not eating or drinking. Orders: Vistaril 15 mg IM q4h, Stat x 1 for nausea. Available: Vistaril 50 mg/mlnHow many mL will you administer to Samantha now?

4 :
A person with digoxin toxicity would have which of these symptoms? (Select All that Apply)

5 :
A patient asks the nurse to explain the medications they are taking. Which medication would be considered an angiotensin converting enzyme inhibitor?

6 :
A doctor orders nine units /kg/hr for a Heparin infusion. The patient weighs 76 kg. You're supplied with a Heparin bag that reads 50 untis/mL. How many mL/hr will you administer? |Round your answer to the nearest tenths)

7 :
Nonpharmacological treatment of heart failure includes:

8 :
Order: Zosyn 1.3g in 100mL. D5W IVPB q8h to infuse over 30 min. Drop factor: 60 gtt/mL. Determine rate in gtt/min.

9 :
Calculate the flow rate in mL/hr. (Equpment used is programmable in whole mL/hr) 180 mL 0.45% NS in 40 min by infusion group

10 :
Before administering digoxin, it is Important for the nurse to do which of the following?